Gas-enhanced energy-based surgical instrument, system, and method for minimally-invasive surgical procedures

ABSTRACT

A surgical system includes a control assembly and a surgical instrument defining a gas inflow path, a gas outflow path, and an end effector configured to apply energy to tissue. The control assembly includes a gas output configured to connect to the gas inflow path, a gas input configured to connect to the gas outflow path, and an energy output configured to supply energy to the end effector. The control assembly further includes a controller to determine an amount of gas output from the gas output, determine an amount of gas withdrawn into the gas input, compare the amount of gas output and the amount of gas withdrawn, and control withdrawal of gas from the gas outflow path such that the amount of gas output and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional PatentApplication Nos. 62/801,151 and 62/801,153, both filed on Feb. 5, 2019,the entire contents of each of which are hereby incorporated herein byreference.

BACKGROUND Technical Field

The present disclosure relates to surgical instruments, systems, andmethods and, more particularly, to gas-enhanced energy-based surgicalinstruments, systems, and methods for use in minimally-invasive surgicalprocedures.

Background of Related Art

In minimally-invasive surgical procedures, operations are carried outwithin an internal body cavity through small entrance openings in thebody. The entrance openings may be natural passageways of the body ormay be surgically created, for example, by making a small incision intowhich a cannula is inserted. However, the restricted access provided byminimally-invasive openings (natural passageways and/or surgicallycreated openings) presents challenges with respect to maneuverabilityand visualization. Thus, in many minimally-invasive surgical procedures,the internal body cavity is insufflated with a gas to distend andseparate the cavity wall from underlying tissue(s), thus improvingmaneuverability and visualization.

Energy-based surgical instruments may be utilized in minimally-invasivesurgical procedures to apply energy to target tissue within the internalbody cavity to achieve a desired tissue effect. Gas-enhancement utilizesa gas (inert gas, energy-activated plasma, etc.) to displace fluid,disperse smoke, and/or facilitate the application of energy from theenergy-based surgical instrument to tissue to achieve the desired tissueeffect, and may likewise be utilized in a minimally-invasive surgicalprocedure.

SUMMARY

As used herein, the term “distal” refers to the portion that isdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, any or all of the aspects described herein, to the extentconsistent, may be used in conjunction with any or all of the otheraspects described herein.

Provided in accordance with aspects of the present disclosure is asurgical system including a surgical instrument and a control assembly.The surgical instrument defines a gas inflow path, a gas outflow path,and an end effector configured to apply energy to tissue. The controlassembly includes a gas output configured to connect to the gas inflowpath of the surgical instrument for supplying gas thereto, a gas inputconfigured to connect to the gas outflow path of the surgical instrumentto withdraw gas therefrom, and an energy output configured to supplyenergy to the end effector of the surgical instrument for application totissue. The control assembly further includes a controller having aprocessor and a non-transitory computer-readable storage medium storinginstructions that, when executed, cause the processor to: determine anamount of gas output from the gas output to the gas inflow path of thesurgical instrument, determine an amount of gas withdrawn into the gasinput from the gas outflow path of the surgical instrument, compare theamount of gas output and the amount of gas withdrawn, and controlwithdrawal of gas from the gas outflow path of the surgical instrumentsuch that the amount of gas output and the amount of gas withdrawn areequal to one another or within a threshold margin of one another.

In an aspect of the present disclosure, the control assembly includes afirst pump configured to pump gas into the gas inflow path of thesurgical instrument. Additionally or alternatively, the control assemblymay include a second pump configured to withdraw gas from the gasoutflow path of the surgical instrument.

In another aspect of the present disclosure, the control assemblyincludes a first sensor configured to sense at least one of: an outputgas flow rate, an output gas pressure, or an output gas volume. In suchaspects, the processor may further be caused to determine the amount ofgas output from the gas output to the gas inflow path of the surgicalinstrument based upon feedback from the first sensor. Additionally oralternatively, the control assembly may include a second sensorconfigured to sense at least one of: an input gas flow rate, an inputgas pressure, or an input gas volume. In such aspects, the processor mayfurther be caused to determine the amount of gas withdrawn into the gasinput from the gas outflow path of the surgical instrument based uponfeedback from the second sensor.

In another aspect of the present disclosure, the control assembly isconfigured to supply gas from the gas output to the gas inflow path ofthe surgical instrument when the energy output supplies energy to theend effector of the surgical instrument for application to tissue.

Another surgical system provided in accordance with aspects of thepresent disclosure includes an electrode configured for insertion intoan insufflated internal body cavity, a gas inflow path configured toextend into the insufflated internal body cavity, a gas outflow pathconfigured to extend out of the insufflated internal body cavity, and acontrol assembly including an energy output configured to supply energyto the electrode, a gas output configured to supply gas along the gasinflow path into the insufflated internal body cavity when energy issupplied to the electrode, and a gas input configured to selectivelywithdrawn gas from the insufflated internal body cavity with the gasoutflow path. The control assembly further includes a controller havinga processor and a non-transitory computer-readable storage mediumstoring instructions that, when executed, cause the processor to:determine an amount of gas supplied into the insufflated internal bodycavity, determine an amount of gas withdrawn from the insufflatedinternal body cavity, compare the amount of gas supplied and the amountof gas withdrawn, and control the withdrawal of gas from the insufflatedinternal body cavity such that the amount of gas supplied and the amountof gas withdrawn are equal to one another or within a threshold marginof one another.

In an aspect of the present disclosure, the electrode is disposed on asurgical instrument and the gas inflow and gas outflow paths are definedthrough the surgical instrument.

In another aspect of the present disclosure, the control assemblyincludes a first pump configured to supply gas and/or a second pumpconfigured to withdraw gas.

In still another aspect of the present disclosure, the control assemblyincludes a first sensor configured to sense at least one of: a gas flowrate, a gas pressure, or a gas volume. In such aspects, the processormay further be caused to determine the amount of gas supplied based uponfeedback from the first sensor.

In yet another aspect of the present disclosure, the control assemblyincludes a second sensor configured to sense at least one of: a gas flowrate, a gas pressure, or a gas volume. In such aspects, the processormay further be caused to determine the amount of gas withdrawn basedupon feedback from the second sensor.

In still yet another aspect of the present disclosure, the controlassembly is housed within an enclosure.

A method provided in accordance with aspects of the present disclosureincludes inserting a surgical instrument into an insufflated internalbody cavity, activating the surgical instrument to apply energy totissue within the insufflated internal body cavity and introduce gasinto the insufflated internal body cavity, determining an amount of gasthat is introduced into the insufflated internal body cavity, andselectively withdrawing gas from the insufflated internal body cavitysuch that an amount of gas that is withdrawn is equal to or within athreshold margin of the amount of gas that is introduced.

In an aspect of the present disclosure, gas is provided from a controlassembly to the surgical instrument for introduction into theinsufflated internal body cavity. In such aspects, the control assemblymay include a first sensor configured to sense at least one propertyindicative of the amount of gas that is introduced to enabledetermination of the amount of gas that is introduced.

In another aspect of the present disclosure, method according to claim14, selectively withdrawing gas includes determining an amount of gas iswithdrawn, comparing the amount of gas that is withdrawn with the amountof gas that is introduced, and determining whether to withdraw gas ornot based upon a result of the comparison.

In yet another aspect of the present disclosure, gas is withdrawn fromthe insufflated internal body cavity into a control assembly. In suchaspects, the control assembly may include a second sensor configured tosense at least one property indicative of the amount of gas that iswithdrawn to enable determination of the amount of gas that iswithdrawn.

Also provided in accordance with aspects of the present disclosure is asurgical instrument including a housing, an elongated shaft assemblyextending distally from the housing, and an end effector extendingdistally from the elongated shaft assembly. The elongated shaft assemblyincludes an inner shaft, an intermediate collar, and an outer sleeve.The inner shaft defines a proximal portion, a distal portion, and alumen extending longitudinally therethrough. The proximal portion of theinner shaft inhibits passage of gas radially therethrough, while thedistal portion of the inner shaft permits passage of gas radiallytherethrough. The intermediate collar is disposed about the inner shaftbetween the proximal portion and the distal portion. The outer sleeve isdisposed about the inner shaft and the intermediate collar. The outersleeve is radially spaced-apart from the inner shaft and abuts an outerperiphery of the intermediate collar to define a proximal annular areabetween the outer sleeve and the inner shaft proximally of theintermediate collar and a distal annular area between the outer sleeveand the inner shaft distally of the intermediate collar. The outersleeve includes a proximal portion surrounding the proximal annular areaand a distal portion surrounding the distal annular area. The proximalportion of the outer sleeve permits passage of gas radiallytherethrough, while the distal portion of the outer sleeve inhibitspassage of gas radially therethrough.

In an aspect of the present disclosure, a distal cap encloses a distalend of the outer sleeve. In such aspects, the end effector may extenddistally through the distal cap.

In another aspect of the present disclosure, the distal cap defines aplurality of openings in communication with the distal annular area topermit passage of gas from the distal annular area through the openings.

In still another aspect of the present disclosure, the plurality ofopenings are disposed radially about the end effector in adistally-oriented direction such that gas passing from the distalannular area through the openings is directed distally about the endeffector.

In yet another aspect of the present disclosure, the distal portion ofthe inner shaft defines a plurality of transverse apertures therethroughto permit passage of gas radially therethrough from the lumen to thedistal annular area.

In still yet another aspect of the present disclosure, the proximalportion of the outer sleeve defines a plurality of slots therethrough topermit passage of gas from an exterior of the outer sleeve radiallytherethrough into the proximal annular area.

In another aspect of the present disclosure, the end effector is engagedwith the inner shaft at a distal end of the inner shaft and encloses thedistal end of the inner shaft.

In yet another aspect of the present disclosure, the end effectorincludes an electrode adapted to connect to a source of energy forapplying energy to tissue.

In another aspect of the present disclosure, the inner shaft is at leastpartially formed from an electrically-conductive material, disposed inelectrical communication with the electrode, and adapted to deliverenergy from a source of energy to the electrode for applying energy totissue.

In still yet another aspect of the present disclosure, an inflow tube isdisposed in communication with the lumen for supplying gas thereto andan outflow tube is disposed in communication with the proximal annularspace for withdrawing gas therefrom.

Another surgical instrument provided in accordance with aspects of thepresent disclosure includes a housing, an elongated shaft assemblyextending distally from the housing, and an end effector extendingdistally from the elongated shaft assembly. The elongated shaft assemblyincludes an inner shaft defining a lumen extending longitudinallytherethrough, an outer sleeve disposed about and radially spaced-apartfrom the inner shaft to define an annular area therebetween, and anintermediate collar disposed between the inner shaft and the outersleeve and dividing the annular area into a proximal annular areaportion and a distal annular area portion. An inflow path is definedthrough the lumen, through openings defined within the inner shaftdistally of the intermediate collar, through the distal annular areaportion of the annular area, and through a distal end of the outersleeve. An outflow path is defined through the proximal annular areaportion and through openings defined within the outer sleeve proximallyof the intermediate collar.

In an aspect of the present disclosure, the openings defined within theinner shaft distally of the intermediate collar are transverseapertures. Additionally or alternatively, the openings defined withinthe outer sleeve proximally of the intermediate collar may belongitudinally-extending slots.

In another aspect of the present disclosure, the elongated shaftassembly further includes a distal cap disposed at distal ends of theinner shaft and outer sleeve. In such aspects, the inflow path throughthe distal end of the outer sleeve may extend through openings definedwithin the distal cap.

In yet another aspect of the present disclosure, the end effectorincludes an electrode adapted to connect to a source of energy forapplying energy to tissue.

In still another aspect of the present disclosure, the inner shaft is atleast partially formed from an electrically-conductive material,disposed in electrical communication with the electrode, and adapted todeliver energy from a source of energy to the electrode for applyingenergy to tissue.

In still yet another aspect of the present disclosure, the outer sleeveis electrically-insulative.

In another aspect of the present disclosure, an inflow tube is disposedin communication with the inflow path for supplying gas thereto and anoutflow tube is disposed in communication with the outflow path forwithdrawing gas therefrom.

In another aspect of the present disclosure, at least one membrane isdisposed about the openings defined within the outer sleeve proximallyof the intermediate collar. The at least one membrane is configured topermit passage of gas therethrough and inhibit passage of liquidtherethrough.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects and features of the present disclosure willbecome more apparent in light of the following detailed description whentaken in conjunction with the accompanying drawings wherein likereference numerals identify similar or identical elements and:

FIG. 1 is an illustration of a minimally-invasive, gas-enhanced,energy-based surgical system provided in accordance with the presentdisclosure shown in a surgical environment;

FIG. 2 is a perspective view of a surgical instrument of the system ofFIG. 1;

FIG. 3 is a perspective view of a distal portion of the instrument ofFIG. 2;

FIG. 4 is a perspective view of the distal portion of the instrument ofFIG. 2 with the outer sleeve and distal cap removed;

FIG. 5 is an enlarged, perspective, longitudinal cross-sectional view ofthe area of detail indicated as “5” in FIG. 3;

FIG. 6 is an enlarged, perspective, longitudinal cross-sectional view ofthe area of detail indicated as “6” in FIG. 3;

FIG. 7 is a perspective view of a control assembly of the system of FIG.1;

FIG. 8 is a schematic diagram of the control assembly of FIG. 7; and

FIG. 9 is a perspective, partial cross-sectional view of the distalportion of the instrument of FIG. 2 in use within an internal bodycavity.

DETAILED DESCRIPTION

The present disclosure provides gas-enhanced energy-based surgicalinstruments, systems, and methods for use in minimally-invasive surgicalprocedures. Although the instruments, systems, and methods of thepresent disclosure are detailed herein configured for use in conjunctionwith one another, it is understood that the instruments, systems, andmethods of the present disclosure also have applicability independentlyof one another and/or with other instruments, systems, and methods.

Referring to FIG. 1, a gas-enhanced energy-based surgical systemprovided in accordance with the present disclosure is shown generallyidentified by reference numeral 10. System 10 includes a surgicalinstrument 100 and a control assembly 200 and is configured for use inminimally-invasive surgical procedures on a patient “P” within aninsufflated internal body cavity “C” (FIG. 9) of the patient “P.”Surgical instrument 100 is configured to supply energy, e.g., RF energy(although other energy modalities such as, for example, microwave,ultrasonic, laser, thermal, etc., are also contemplated), to tissue toachieve a desired tissue effect. Surgical instrument 100 is furtherconfigured to supply a gas, e.g., an inert gas, an energy-activatedplasma, etc., at the site of energy application to facilitate achievingthe desired tissue effect by, for example, displacing fluid, dispersingsmoke, and/or facilitating the application of energy to tissue. Surgicalinstrument 100 is also configured to withdraw gas from the insufflatedinternal body cavity “C” (FIG. 9) to maintain an appropriateinsufflation pressure within the insufflated internal body cavity “C”(FIG. 9). Surgical instrument 100 is described in greater detail below.

Control assembly 200 of system 10 may be configured as a single unithoused within an enclosure 210 (as illustrated in FIG. 1) or may includeseveral sub-units operably coupled to one another (in close proximity orremote from one another). Control assembly 200 is coupled to surgicalinstrument 100 and is configured to supply and control the supply ofenergy to tissue via surgical instrument 100, supply and control thesupply of gas to the site of energy application via surgical instrument100, and withdraw and control the withdrawal of gas from the insufflatedinternal body cavity “C” (FIG. 9) via surgical instrument 100. Controlassembly 200 is described in greater detail below.

Turning to FIGS. 2-6, and initially to FIG. 2, surgical instrument 100generally includes a housing 120, an elongated shaft assembly 140extending distally from housing 120, an end effector 160 extendingdistally from elongated shaft assembly 140, and a connection assembly180 operably coupled to housing 120 and configured to operably connectsurgical instrument 100 to control assembly 200 (FIG. 1). Surgicalinstrument 100 may be configured as a disposable, single-use instrument;a reusable, multi-use instrument capable of being sterilized forrepeated use; or a reposable instrument wherein some portions arecapable of being sterilized for repeated use and other portions aredisposable, single-use portions that are replaced after each use.

Continuing with reference to FIG. 2, housing 120 includes a body portion122 an a fixed handle portion 124 extending perpendicularly or obliquelyfrom body portion 122 to provide an ergonomic pistol-grip configurationfacilitating grasping and manipulating housing 120, although othersuitable configurations, e.g., a pencil-grip configuration, are alsocontemplated. Housing 120 further includes an energy activation button126, a gas supply activation button 128, and a rotation wheel 130,although additional or alternative controls are also contemplated.

With reference to FIGS. 3-6, elongated shaft assembly 140, as notedabove, extends distally from housing 120 (FIG. 2). A proximal portion(not shown) of elongated shaft assembly 140 is disposed within housing120 and operably coupled to rotation wheel 130 (FIG. 2) within housing120 to enable rotation of elongated shaft assembly 140 relative tohousing 120 in response to rotation of rotation wheel 130 relative tohousing 120. Elongated shaft assembly 140 extends from the proximalportion thereof, distally from housing 120, to end effector 160.

Elongated shaft assembly 140 includes an inner shaft 142, an outersleeve 144, and a distal cap 146. Referring to FIGS. 4 and 5, innershaft 142 is formed at least partially from an electrically-conductivematerial, includes a proximal portion 148 and a distal portion 150 (ofsimilar or different length), and defines a longitudinally-extendinglumen 152 therethrough. An intermediate collar 154 is disposed aboutinner shaft 142 between proximal portion 148 and a distal portion 150thereof. Proximal portion 148 of inner shaft 142 defines a solid outerannular surface; that is, proximal portion 148 of inner shaft 142 isconfigured to inhibit the passage of gas between lumen 152 and theradial exterior of proximal portion 148 of inner shaft 142. Distalportion 150 of inner shaft 142, defines a plurality of transverseapertures 151 therethrough arranged annularly about and longitudinallyalong at least a portion thereof in any suitable arrangement and/orpattern. Apertures 151 enable the passage of gas radially between lumen152 and the exterior of distal portion 150 of inner shaft 142.

Referring to FIGS. 3, 5, and 6, outer sleeve 144 of elongated shaftassembly 140 is formed from an electrically-insulative material, coatedwith an electrically-insulated material, or otherwise configured toinhibit the conduction of electrical energy therethrough. Inembodiments, outer sleeve 144 is formed from, for example, woven carbonfiber or a biocompatible polymer. Outer sleeve 144 is disposed about andradially-spaced from inner shaft 142 of elongated shaft assembly 140 todefine a proximal annular space 156 a between outer sleeve 144 andproximal portion 148 of inner shaft 142 and a distal annular space 156 bbetween outer sleeve 144 and distal portion 150 of inner shaft 142.Outer sleeve 144 abuts the outer radial surface of intermediate collar154 to establish a seal therebetween to inhibit gas exchange betweenproximal annular space 156 a and distal annular space 156 b. Theabutment of outer sleeve 144 with intermediate collar 154 also serves tomaintain inner shaft 142 in concentric position within outer sleeve 144,thus maintaining proximal and distal annular spaces 156 a, 156 b,respectively, between inner shaft 142 and outer sleeve 144.

Outer sleeve 144 includes a proximal portion 158 a surrounding proximalannular space 156 a and a distal portion 158 b surrounding distalannular space 156 b. Proximal portion 158 a of outer sleeve 144 definesa plurality of longitudinally-extending slots 159 a therethrougharranged annularly about and longitudinally along at least a portionthereof in any suitable arrangement and/or pattern. Slots 159 a enablethe passage of gas radially between proximal annular space 156 a and theexterior of proximal portion 158 a of outer sleeve 144. Distal portion158 b of outer sleeve 144, on the other hand, defines a solid outerannular surface; that is, distal portion 158 b of outer sleeve 144 isconfigured to inhibit the passage of gas between distal annular space156 b and the radial exterior of distal portion 158 b of outer sleeve144.

Outer sleeve 144, in embodiments, may further include one or moremembranes 159 b disposed at least about slots 159 a. Each membrane 159 bmay be a hydrophobic membrane or other suitable membrane that enablesthe exchange of gas therethrough but inhibits the exchange of liquidstherethrough. Suitable membranes include, for example, microporous PTFEand GOR-TEX®, available from W.L. Gore & Associates GmbH.

Referring to FIGS. 3 and 5, distal cap 146 of elongated shaft assembly140 is disposed at the distal ends of inner shaft 142 and outer sleeve144 and may define a semi-spherical configuration (as illustrated), afrustoconical configuration, or other suitable configuration. Distal cap146 encloses the distal end of distal annular space 156 b and defines aplurality of radially-arranged apertures 147 defined therethrough andoriented in a generally distally-facing direction. Apertures 147 thusenable gas disposed within distal annular space 156 b to exit surgicalinstrument 100 through apertures 147 in a distal direction radiallyabout end effector 160, as detailed below.

Continuing with reference to FIGS. 3 and 5, end effector 160 includes ahub 162 and an electrode 164 extending distally from hub 162. Hub 162 isengaged, e.g., welded, with distal portion 150 of inner shaft 142 at thedistal end of distal portion 150 to seal off the distal end of lumen152. Hub 162 is formed at least partially from anelectrically-conductive material and is electrically coupled to innershaft 142, e.g., via direct mechanical contact therebetween. Electrode164 is likewise formed at least partially from anelectrically-conductive material and extends distally from hub 162.Electrode 164 may be engaged with, monolithically formed with, orotherwise coupled to hub 162 in electrical communication therewith. Endeffector 160 is fixed relative to elongated shaft assembly 140 such thatend effector 160 is rotated in conjunction with elongated shaft assembly140 and relative to housing 120 (FIG. 2), e.g., in response to rotationof rotation wheel 130 relative to housing 120 (see FIG. 2).

Electrode 164, as noted above, extends distally from hub 162. Morespecifically, electrode 164 extends distally through a central openingdefined through distal cap 146 and distally of elongated shaft assembly140. Electrode 164 fully occupies the central opening of distal cap 146or is otherwise sealed therein to inhibit the passage of gas through thecentral opening between electrode 164 and distal cap 146. Electrode 164is also radially surrounded by and extends distally from apertures 147of distal cap 146. As such, gas exiting elongated shaft assembly 140distally through apertures 147 is directed radially about electrode 164and distally towards the distal-most end of electrode 164. Electrode 164may define a distal portion 166 having any suitable configuration tofacilitate communicating energy to tissue such as, for example, ahook-shape (as illustrated) or other suitable shape.

With reference back to FIGS. 1 and 2, connection assembly 180 ofsurgical instrument 100 includes a cable 182, and inflow tube 184, andan outflow tube 186 disposed within an outer sheath 188, although cable182, inflow tube 184, and/or outflow tube 186 may alternatively beconnected to one another without an outer cable sheath, may be separatefrom one another, or may be configured in any other suitable manner.Cable 182 includes a plug 183 at the proximal end thereof configured toconnect surgical instrument 100 to an energy output 202 of controlassembly 200. Cable 182 extends distally through outer sheath 188 intohousing 120, wherein a lead wire (not explicitly show) extending throughcable 182 is electrically connected to inner shaft 142 of elongatedshaft assembly 140, e.g., via a slip-ring connection (not shown). Thus,energy, e.g., RF energy, may be delivered from control assembly 200 toelectrode 164 via the lead wire of cable 182 and inner shaft 142 forapplication to tissue to achieve a desired tissue effect. Cable 182 mayadditionally house one or more control wires (not explicitly shown)configured to connect energy activation button 126 and/or gas supplyactivation button 128 to control assembly 200 to enable the selectiveactivation of energy and/or gas supply from control assembly 200 tosurgical instrument 100.

Inflow tube 184 of connection assembly 180 includes a plug 185 at theproximal end thereof configured to connect surgical instrument 100 to agas output 204 of control assembly 200. Inflow tube 184 extends distallythrough outer sheath 188 into housing 120, wherein the distal end ofinflow tube 184 is disposed in communication with lumen 152 of innershaft 142 in sealed relation. Thus, gas, e.g., an inert gas such as CO₂,may be delivered from control assembly 200 to lumen 152 via inflow tube184. More specifically, gas may be pumped through inflow tube 184 andlumen 152, exiting lumen 152 and entering distal annular space 156 b viatransverse apertures 151 defined within distal portion 150 of innershaft 142, and exiting distal annular space 156 b through apertures 147of distal cap 146 such that the gas is expelled distally into theinternal body cavity “C” (FIG. 9) about electrode 164 to facilitateachieving the desired tissue effect, e.g., via displacing fluid,dispersing smoke, and/or facilitating the application of energy fromelectrode 164 to tissue.

Outflow tube 186 of connection assembly 180 includes a plug 187 at theproximal end thereof configured to connect surgical instrument 100 to agas input 206 of control assembly 200. Outflow tube 186 extends distallythrough outer sheath 188 into housing 120, wherein the distal end ofoutflow tube 184 is disposed in communication with proximal annularspace 156 a defined between inner shaft 142 and outer sleeve 144, insealed relation. Thus, gas may be draw from the internal body cavity “C”(FIG. 9) into proximal annular space 156 a via slots 159 a (and throughmembrane(s) 159 b) of outer sleeve 144, proximally through proximalannular space 156 a, into and through outflow tube 186, and, ultimately,to control assembly 200 for collection, recycling, exhausting, etc.

Referring generally to FIGS. 1-6 and 9, end effector 160 and elongatedshaft assembly 140 of surgical instrument 100 are configured forminimally-invasive insertion into an insufflated internal body cavity“C,” e.g., through an access port “A,” while housing 120 of surgicalinstrument 100 remains externally disposed to enable manipulation and/oractivation of surgical instrument 100. Once inserted in this manner,surgical instrument 100 may be activated to supply energy to tissue “T”via electrode 164, supply a gas about electrode 164 adjacent tissue “T”to facilitate achieving a desired tissue effect, and withdraw gas fromthe insufflated internal body cavity “C” (while, in embodiments, alsoinhibiting the withdrawal of liquids from the insufflated internal bodycavity “C”) at positions proximally-spaced from electrode 164 and tissue“T” so as not to interfere with the application of energy to tissueand/or the supplied input gas.

Turning to FIGS. 1 and 7-9, control assembly 200, as noted above,includes energy output 202 configured to supply energy to surgicalinstrument 100, a gas output 204 configured to supply gas to surgicalinstrument 100, and a gas input 206 configured to withdraw gas fromsurgical instrument 100. Control assembly 200, as also noted above, maybe housed within a single enclosure 210 (as shown) or may be acombination of sub-assemblies coupled to one another. Enclosure 210(and/or one or more of the sub-assemblies, in embodiments whereprovided) may further include a display screen 220, which may be atouch-screen display to enable input as well as to provide a visualoutput. Other input and/or output components are also contemplated suchas, for example, speakers, LEDs, keypads, etc.

With particular reference to FIG. 8, control assembly 200 furtherincludes an RF generator 212 configured to convert power, e.g., from awall outlet (not shown), into electrosurgical RF energy for output toenergy output 202 such that RF energy may be delivered from controlassembly 200 to electrode 164 of surgical instrument 100 (see FIG. 1)for application to tissue “T” (FIG. 9). Control assembly 200 alsoincludes or is coupled to a gas source 214 and a pump 224 coupledbetween gas source 214 and gas output 204 to enable gas to be pumpedfrom gas source 214 through surgical instrument 100 and into theinternal body cavity “C” about end effector 160 (see FIG. 9), asdetailed above. Control assembly 200 additionally includes or is coupledto a gas reservoir 216 and a pump 226 coupled between gas reservoir 216and gas input 206 to enable gas to be withdrawn, e.g., suctioned, fromthe internal body cavity “C” via instrument 100 (see FIG. 9), asdetailed above, for depositing in gas reservoir 216.

Referring again to FIGS. 1 and 7-9, control assembly 200 also includes acontroller 230 including, for example, a microcontroller and a storagemedium storing instructions to be executed by the microcontroller.Controller 230 is configured to receive input information from surgicalinstrument 100, e.g., activation signals from energy activation button126 and/or gas supply activation button 128, and direct an appropriateoutput, e.g., the supply of energy to electrode 164 or the output of gasto surgical instrument 100. Controller 230 may be configured toautomatically output gas to surgical instrument 100 when energy issupplied to surgical instrument 100 (concurrently or delayed relativethereto) and/or may be configured to output gas to surgical instrument100 in response to activation of gas supply activation button 128.

Controller 230 is further configured to monitor the amount, e.g.,volume, of gas output to surgical instrument 100 and, thus, the amountof gas input into the internal body cavity “C.” This may be accomplishedusing a sensor 234 configured to sense a flow rate of gas output viapump 224 (or at any other suitable location) such that, knowing thedimensions of the components within the gas output flow path, controller230 can determine the amount of gas input into the internal body cavity“C.” Alternatively, sensor 234 may be configured to sense a pressureand/or volume difference within gas source 214 such that controller 230can correlate the same to the amount of gas pumped into the internalbody cavity “C.” As another alternative, sensor 234 may be configured tomonitor the power consumption, torque, impedance, and/or other suitableparameter(s) of pump 224 and correlate the same to an amount to enablecontroller 230 to determine the amount of gas pumped to surgicalinstrument 100 and, thus, the amount of gas input into the internal bodycavity “C.” As still another alternative, sensor 234 may be configuredto monitor the “ON” time of pump 224 such that controller 230, knowingthe output of pump 224, can determine the amount of gas input into theinternal body cavity “C.” Other suitable configurations of sensor 234for determining the amount of gas input into the internal body cavity“C” are also contemplated. The amount of gas input into the internalbody cavity “C” is stored in a memory of controller 230 and updatedcontinuously or periodically.

Continuing with reference to FIGS. 1 and 7-9, controller 230 is alsoconfigured to control pump 226, thereby controlling the withdrawal ofgas from the internal body cavity “C” via instrument 100, for ultimatedepositing in gas reservoir 216. More specifically, controller 230 isconfigured to control the withdrawal of gas from the internal bodycavity “C” in accordance with the determined amount of gas input intothe internal body cavity “C” such that the amount of gas withdrawn isequal to or within a threshold margin of the amount of gas input. Thethreshold margin may be an absolute value, e.g., a numerical volume, ora relative value, e.g., a percentage of the input volume. As such, theamount of gas within the insufflated internal body cavity “C” (absentother factors contributing to the addition or loss of gas) is maintainedconstant or within a threshold range throughout use of surgicalinstrument 100. Thus, the pressure within the insufflated internal bodycavity “C” (absent other factors contributing to the addition or loss ofpressure) is also maintained constant or within a threshold rangethroughout use of surgical instrument 100.

Controller 230 controls the withdrawal of gas from the internal bodycavity “C,” in embodiments, by monitoring the amount of gas withdrawnfrom the internal body cavity “C,” comparing the amount of gas withdrawnto the amount of gas input (stored in the memory of controller 230), andselectively operating pump 226 to ensure the amount of gas withdrawn isequal to or within a threshold margin of the amount of gas input.Controller 230 may utilize a sensor 236 such as, for example, a flowrate sensor, a pressure and/or volume sensor, a pump parameter sensor,an “ON” time sensor, etc. (similarly as detailed above with respect tosensor 234), to determine the amount of gas withdraw from the internalbody cavity “C.” Controller 230 may compare the determined input andwithdrawn amounts continuously or periodically, and automaticallycontrol activation (and deactivation) of pump 226 to withdraw gas asnecessary to ensure that the amount of gas and/or pressure within theinsufflated internal body cavity “C” (absent other factors) ismaintained constant or within a threshold range throughout use ofsurgical instrument 100.

From the foregoing and with reference to the various drawings, thoseskilled in the art will appreciate that certain modifications can bemade to the present disclosure without departing from the scope of thesame. While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. A surgical system, comprising: a surgicalinstrument defining a gas inflow path, a gas outflow path, and an endeffector configured to apply energy to tissue; and a control assemblyincluding a gas output configured to connect to the gas inflow path ofthe surgical instrument for supplying gas thereto, a gas inputconfigured to connect to the gas outflow path of the surgical instrumentto withdraw gas therefrom, and an energy output configured to supplyenergy to the end effector of the surgical instrument for application totissue, the control assembly further including a controller having aprocessor and a non-transitory computer-readable storage medium storinginstructions that, when executed, cause the processor to: determine anamount of gas output from the gas output to the gas inflow path of thesurgical instrument; determine an amount of gas withdrawn into the gasinput from the gas outflow path of the surgical instrument; compare theamount of gas output and the amount of gas withdrawn; and controlwithdrawal of gas from the gas outflow path of the surgical instrumentsuch that the amount of gas output and the amount of gas withdrawn areequal to one another or within a threshold margin of one another.
 2. Thesurgical system according to claim 1, wherein the control assemblyincludes a first pump configured to pump gas into the gas inflow path ofthe surgical instrument.
 3. The surgical system according to claim 1,wherein the control assembly includes a second pump configured towithdraw gas from the gas outflow path of the surgical instrument. 4.The surgical system according to claim 1, wherein the control assemblyincludes a first sensor configured to sense at least one of: an outputgas flow rate, an output gas pressure, or an output gas volume, andwherein the processor is further caused to determine the amount of gasoutput from the gas output to the gas inflow path of the surgicalinstrument based upon feedback from the first sensor.
 5. The surgicalsystem according to claim 1, wherein the control assembly includes asecond sensor configured to sense at least one of: an input gas flowrate, an input gas pressure, or an input gas volume, and wherein theprocessor is further caused to determine the amount of gas withdrawninto the gas input from the gas outflow path of the surgical instrumentbased upon feedback from the second sensor.
 6. The surgical systemaccording to claim 1, wherein the control assembly is configured tosupply gas from the gas output to the gas inflow path of the surgicalinstrument when the energy output supplies energy to the end effector ofthe surgical instrument for application to tissue.
 7. A surgical system,comprising: an electrode configured for insertion into an insufflatedinternal body cavity; a gas inflow path configured to extend into theinsufflated internal body cavity; a gas outflow path configured toextend out of the insufflated internal body cavity; and a controlassembly including an energy output configured to supply energy to theelectrode, a gas output configured to supply gas along the gas inflowpath into the insufflated internal body cavity when energy is suppliedto the electrode, and a gas input configured to selectively withdrawngas from the insufflated internal body cavity with the gas outflow path,the control assembly further including a controller having a processorand a non-transitory computer-readable storage medium storinginstructions that, when executed, cause the processor to: determine anamount of gas supplied into the insufflated internal body cavity;determine an amount of gas withdrawn from the insufflated internal bodycavity; compare the amount of gas supplied and the amount of gaswithdrawn; and control the withdrawal of gas from the insufflatedinternal body cavity such that the amount of gas supplied and the amountof gas withdrawn are equal to one another or within a threshold marginof one another.
 8. The surgical system according to claim 7, wherein theelectrode is disposed on a surgical instrument, and wherein the gasinflow and gas outflow paths are defined through the surgicalinstrument.
 9. The surgical system according to claim 7, wherein thecontrol assembly includes a first pump configured to supply gas.
 10. Thesurgical system according to claim 7, wherein the control assemblyincludes a second pump configured to withdraw gas.
 11. The surgicalsystem according to claim 7, wherein the control assembly includes afirst sensor configured to sense at least one of: a gas flow rate, a gaspressure, or a gas volume, and wherein the processor is further causedto determine the amount of gas supplied based upon feedback from thefirst sensor.
 12. The surgical system according to claim 7, wherein thecontrol assembly includes a second sensor configured to sense at leastone of: a gas flow rate, a gas pressure, or a gas volume, and whereinthe processor is further caused to determine the amount of gas withdrawnbased upon feedback from the second sensor.
 13. The surgical systemaccording to claim 7, wherein the control assembly is housed within anenclosure.
 14. A method, comprising; inserting a surgical instrumentinto an insufflated internal body cavity; activating the surgicalinstrument to apply energy to tissue within the insufflated internalbody cavity and introduce gas into the insufflated internal body cavity;determining an amount of gas that is introduced into the insufflatedinternal body cavity; and selectively withdrawing gas from theinsufflated internal body cavity such that an amount of gas that iswithdrawn is equal to or within a threshold margin of the amount of gasthat is introduced.
 15. The method according to claim 14, wherein gas isprovided from a control assembly to the surgical instrument forintroduction into the insufflated internal body cavity, and wherein thecontrol assembly includes a first sensor configured to sense at leastone property indicative of the amount of gas that is introduced toenable determination of the amount of gas that is introduced.
 16. Themethod according to claim 14, wherein selectively withdrawing gasincludes determining an amount of gas is withdrawn, comparing the amountof gas that is withdrawn with the amount of gas that is introduced, anddetermining whether to withdraw gas or not based upon a result of thecomparison.
 17. The method according to claim 16, wherein gas iswithdrawn from the insufflated internal body cavity into a controlassembly, and wherein the control assembly includes a second sensorconfigured to sense at least one property indicative of the amount ofgas that is withdrawn to enable determination of the amount of gas thatis withdrawn.